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POR CIT1'LiSG ONLY <br /> " '` City of OCono Datc Rcceived: Pcrmit# <br /> ,_ O-_ <br /> �;�g ��� P.O.Bos 66 <br /> �%�,. �\�;� �7�0 t�elle}'Park��ay ❑In-EIouse SAC Detcnnination�orm Completcd <br /> �� 1�:�'� ` ��� Crystal Bay,MN��323 <br /> �� ��,' ",r o`� (9�2)2a9-=1600 Approved Sy([f Required): � <br /> ��"'Kz^siao�`$>� <br /> CITY OF ORONO— SCWER & WATE12/ G�NERAL PEI2MIT <br /> (*\ote:Some pennits inay re�yuire approv�!by the I3uildin,Official and/or Public Works Department*) <br /> (r�Lt.PI;Ri1I1"I�S- ��fav bc sublect to furthcr revicw and m;n'not be issuccl�vlien thc aPplic.ition ic recci��cd) <br /> GTN�RAL 1NFORMA'1'ION <br /> 1. You may apply for utility permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee sho�-vn below. Permit cards will <br /> � be sent b,y return mail wilhin�2 business days. <br /> 3. Permits arc not valid u�itil you receive� permit card. <br /> 4. �Vork must not be�,in unless the permit card is available on the iob site. <br /> � 5. Utility connection permits may be issued to licei�sed contractors only. � <br /> 6. Coi�tact the P�iblic �Vorks De�artment(952-249-4600) for utility stub as-built locations. <br /> DO NO"I' E�CAVATE IN Al�l'STRGE"I`AND DO N07'1'AP ANY NIA[N without express <br /> � �ipprov�l of the Public�Vo►•Ics Deplrtmcnt. lssuance of a permit does not grant tliis appi-oval. <br /> 7. All �vorl:must bc done in accordance with State Code requirements. <br />� S. All worlc must be inspected before it is covered. Call(952)?49-�i600,24+hour notice requirecl. <br /> TYPE OF PERNIIT <br /> (Checl<�11 That Apply) � <br /> �esidential (May Require Approval) � Commercial (Approval Requirecl) <br /> �r�Connection I� Additional Coiulection � Re-Connection �� Repairs � Disconnect <br /> Job Site/ Owner Info►-tnation: <br /> Site Address: �.� �� �-� ��/1•� � <br /> � <br /> � <br /> R <br /> U��'llef: � Nlc�llllla ACICII'eSS: <br /> City: ��� �i.��� : 7ip: <br /> � Home I'IZo»e:��'�— �1�� ��'�� Alteri7ate Phoile: <br /> I <br /> C011il'aClOI' �I1t01'lllallOtl: <br /> � <br /> � C011tl'2CtOC�LL L��I�j-L �(_��� C011l�iCt �el'SOII: c�`l7 <br /> � \� � <br /> Address:a��- �� � � -��-(J State L icense #: �� ,}�� <br /> Cit�-: � � 7_,ip��!",��piration Date: �' <br /> Pllone:�lv�-- ���` ��� / Altei-t�ate Phone: ���,� �/ � �,��� <br />